Normal kidney arrangement assumes their presence on both sides of the spinal column. However, their boundaries are defined by 11-12 thoracic and lumbar vertebrae 1-2. Changing the boundary of more than 3 cm - is the kidney offset.Normal kidney arrangement
Basis normal kidney arrangement
Their arrangement is normally provided by a number of anatomical structures.
1. Renal bed - recess in the back muscles.
2. Renal fascia - connective sheets coming from the diaphragm and surrounding the kidney from the front and rear sides.
3. Ligaments. Connective tissue bands that connect them to the adjacent units. The right kidney is fixed by two ligaments: hepato-renal and renal-duodenal (from the word "duodenum" - the duodenum). The left connected to the pancreas and spleen by respective bundles: pancreat-reno-renplnaya and splenic.
4. Adipose capsule. Interlayer adipose tissue located directly between the fascia and kidney.
Vascular "leg". It consists of the renal vessels. That is, from a vein and an artery.
It is important! Accordingly, the offset data is the result of weakening of binding structures. Moreover attenuation fascia and ligaments are major contributors to the development bias, as they represent the main body locking apparatus.
The causes of displacement
kidney ptosisAll of the major causes of displacement are embedded in their attachment apparatus.
The weakening of the ligaments and fascial bed. It occurs under the action of a number of precipitating factors. First of all it refers to the waist injury, chronic disease retroperitoneal prostranstanstva and neighboring organs. Thus weakening hepatorenal ligament is often observed in chronic hepatitis. The same is observed in chronic zpbolnvaniyah duodenum. The weakening of the ligamentous apparatus can be connected to by the kidneys. Also weaken fascial-svyazachnogo berenoznost apparatus may result. This fact is confirmed by the fact that the shift in women occurs several times more frequently than men.
Depletion of fat capsule. It is the result of drastic weight loss. It is often seen in severe general trauma, chronic diseases, malnutrition.
For example, a lower renal vascular location creates an additional condition for omission.
Clinic offset to a large extent does not depend on the presence of ptosis and its degree of severity. In this connection, there are three stages of ptosis.
1. The first stage occurs when a slight shift. It occurs at a distance equal to at least 1/3 of the length of the kidney. It is about 6-7 centimeters.
2. For the second stage characterized by a significant displacement. Kidney almost entirely falls below the costal arch.
3. The third stage is characterized by an even more significant displacement. Body can be up to the pelvis.
It is important! The main symptom of displacement (and often only) is a pain. Her appearance is different at different stages.
organ prolapse stageSo the first stage is characterized by persistent pain are not so stupid aching pain in the lumbar region. They do not occur often and for a long time. In this case, for palpation is available only to the lower third of the kidney.
In the second stage, the pain becomes more persistent and more severe. Palpable almost the entire kidney. Thus palpation painful due to overstimulation fascia pain receptors.
On the third stage, the pain is almost constant. Often, they can be given to the respective iliac region of the abdomen. The kidney continuously accessible to palpation.
In addition to pain, the various mental disorders can occur in displacement. So much for the male subjects suffering from kidney ptosis often observed hypochondriacal mood, irritability. For women, the most characteristic hysteroid reaction.
The main body bias complications include various inflammatory and noninflammatory diseases.
1. Inflammatory complications arise as a consequence of the fact that the DC offset negative impact on urodynamics - discharge of urine. This creates conditions for the emergence of foci of chronic infection. The most common of these are pyelonephritis and glomerulonephritis.
2. For non-inflammatory diseases include the following diseases:
Hydronephrosis - accumulation of fluid in the kidney tissues. As a result, the body is almost completely excluded from the "work".
Urolithiasis disease. The formation of concretions of uric acid crystals is due to the violation of a discharge of urine, so - as a result of its stagnation.
renal infarction. It is one of the most dangerous complications of the third stage Nephroptosis. The mechanism of occurrence is associated with pathological processes that are taking place during the displacement. Firstly, a significant nephroptosis can lead to clamping renal vessels, which is the basis of its tissue ischemia. Second, the DC offset creates favorable conditions for thrombus formation.
Diagnosing kidney displacement
For the diagnosis of bias on the history besides valuable presents palpation, percussion, and instrument diagnostics.
Laboratory changes are not informative, since in the absence of complications, compensatory abilities of healthy kidneys is quite able to cope with the basic functions of the excretory system.